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General NPI Number Information
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NPI Number | 1922068493
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Entity Type | Individual
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Provider Name | MICHAEL S NICKELS M.D., PH.D
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Gender | Male
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Dates
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Enumeration Date | 03/27/2006
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Last Update Date | 04/17/2013
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Provider Practice Location Address
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Address Line | 1620 S QUEEN ST
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City | YORK
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State | PA
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Zip | 17403-4637
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Country | US
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Telephone | 717-843-6663
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Fax | 717-852-0670
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Provider Business Mailing Address
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Address Line | 1620 S QUEEN ST
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City | YORK
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State | PA
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Zip | 17403-4637
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Country | US
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Telephone | 717-843-6663
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Fax | 717-852-0670
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | MD424414
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License Number State | PA
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